Oklahoma Ranks DEAD Last in Health Care!!

[okclee]

So it is just coincidence that all of these studies, lists, and rankings, are flawed against Oklahoma?

The details that determine the aformentioned are not set up to make Oklahoma at the top of one of these studies.


Also the US news lists of top 200 hospitals of 2006, there are many hospitals that are on that list from states that compare in size to Okla.

[CuatrodeMayo]

In 11 of the 16 specialties, hard data largely determine a hospital's position. (In the others five, as explained below, the rankings are based only on hospitals' reputation among specialist physicians.) Initial eligibility for these data-driven specialties requires a hospitals to meet any of three standards: membership in the Council of Teaching Hospitals, affiliation with a medical school, or—to open the door to non-teaching hospitals—availability of at least nine out of 18 key technologies like shaped beam radiation, an advanced cancer therapy. This year, fewer than a third of the hospitals qualified.

We didn't make the top 1/3...whoopee. Certainly not the worst hospitals.

[okclee]

I do know that University of Oklahoma will be building a world class Diabetes Center along with the Cancer Center at the Okc OU campus.

I would think that the fact that our state has neither a cancer center nor a diabetes center right now puts us at the bottom in health related studies.

[jbrown84]

The Oklahoma Medical Research Foundation is one of the top 12 private medical research institutions in the country, so there's a ranking that doesn't reflect so poorly on the medical field here.

okclee, you keep lumping in the health-related rankings with HEALTH CARE. We do deserve to be at the bottom of these lists when it comes to healthy lifestyle, but two surveys published by east coast magazines does not convince me that we have THE worst quality of care from physicians or THE worst equity among all income and social levels.

[okclee]

jbrown....... I hear what you are saying, but don't you think that the healthy lifestyle is somehow connected to the health care in Okla. and vice versa??

If we had a healthier lifestyle in Okla then our doctors would look better, and if our healthcare system was better in Okla then we could lead a healthier lifestyle.


Does anyone remember just a few years ago that many of Okla top doctors were leaving the state because of the Okla legislature and tort reform?

[jbrown84]

Healthy lifestyle when it comes to how we eat and how we exercise is cultural. The knowledge and skill of local doctors to treat your cancer or your diabetes has nothing to do with that. Our medical education system is far from the worst in the country and has actually improved immensely under the watch of David Boren.

I think tort reform is just one tiny issue in all of this. Its something to work on most definitely, but the incident you're talking about was (not surprisingly) blown way out of proportion by the sensationalists at KOCO and KFOR and probably even KWTV.

[Kerry]

Soonerdave - I salute you

Just for fun, here are the people who authored the reports cited by OKCLEE:

Best and Worst Cities for Men 2007 - Jeff O'Connell, Men's Health

Merograde: Ranking America's City - Jeff O'Connell, Men's Health

The Fast-food Capital of America - Fortune doesn't site any reports, just anecdotal evidence.

The Fattest and Fittest Cities - Jeff O'Connell, Men's Health

The Best Walking Cities - Jeff O'Connell, Editor of Prevention Magazine

This Jeff O'Connel guy seems to be very busy. Guess what Jeff's other occupation is. He sells excercise books and videos. I guess if you tell the same story over and over people will start to believe it. Not exactly an impartial researcher.

[okclee]

Jeff O'Connell is the chief editor of Men's Health Magazine and not the author.

Three of those sources are from Mens Health Magazine, which is considered to be reputable magazine and not just some random blog.

[Kerry]

He is the author of these reports also. I guess "reputable" is in the eye of reader. One person does a so-called study and present his findings in 5 different places, then use those 5 references to help sell his excerise merchandise. What part is reputable? Did you notice that personal income is used in all of his calculations of health?

[Kerry]

I would think that the fact that our state has neither a cancer center nor a diabetes center right now puts us at the bottom in health related studies.

This is the problem, the studies you cited didn't look at this knd of criteria. They focused on things like time spent commuting, how many days people went to the gym, is the scenery pleasant, and how many Sonics there are. Another problem I have is that none of these tell you how the criteria are weighted or even if having more of something is considered bad or good. In fact, we never get to see the raw data to verify anything. And I am quite sure there is no peer review (although that has problems also). Crap, I should start my own think tank and start publishing my own reports.

[okclee]

I guess if it is negative toward Okla or Okc the something is wrong with the study or the report.

This message board is filled with links to websites touting Okla or Okc at the top of many lists in the U.S. and nobody ever questions the criteria or the source.

It is all about if the news is good then hooray for Okla, but if the news is bad then the study is biased or there is an agenda or the facts are incomplete.

Don't shoot the messenger.

[Kerry]

I'm not try to shoot the messenger, but I can see why it looks that way. Just for the record, I am also skeptical on the good new also. A few years ago Tulsa was ranked as one of the top 10 best place to live. However, a little investigative research revealed that Tulsa paid $20,000 to get on the list. Several years ago I believed all of the surveys also, but now I question everything. Usually it is people trying to influence personal political agendas or selling something. There are still people doing real research but they are getting few and far between.

[SoonerDave]

okclee,

No offense, but you're missing the point of my (and others) criticism.

The point is that these are strawman arguments made by someone with a vested interest in the results turning out a certain way. A report by a health editor is just as non-neutral as, say, a report on how healthy hamburgers are by someone from Wendy's\. The point is that these aren't meaningful pieces of evidence to demonstrate the points they intend to demonstrate, and that's often because the base criteria you might [I]expect/I] to be used doesn't make the point as well as you'd like.

The use of "relative" rates of something (whatever it may be) versus "absolute" rates is a classic misuse of statistics. The "fattest city" report is an inflammatory title that cites just about everything except average weight statistics to support its claim - gym memberships, driving time, etc. A "fattest city" list should be just that - a list of the cities with the highest average per-capita weights for its citizens. Because the distribution of overweight people might not be as pronounced in that vein, the author added other criteria that have nothing to do with how "fat" someone is to embellish their point.

If studies and surveys have a valid point to make, they shouldn't have to rely on secondary data to prove their "point." It isn't about ignoring Oklahoma problems, it's about the reaction to incendiiary polls, studies, and surveys merely on their face rather than studying the techniques and motivations behind them - no matter how laudable they seem.

A classic adjunct to this statistics abuse issue is the way cholesterol lowering medications are sold to the public, with almost no reporting of the change in absolute risk for coronary disease for taking statin drugs. The change in absolute risk is astonishingly small, but milllions of people dutifully take their statins under the false impression that they drastically reduce their risk factor for taking them - while drug companies make billions as a result. It's a sad commentary that none of our so-called "news" organizations have investigated what I think is a monumental fraud being perpetrated on the medical consumer, but that's a different issue.

I guess, to a degree, I'm repeating myself, and I'm sorry for that. I have no problem with simple, sound surveys and research that wants an objective conclusion, whether it is positive or negative for me or you or Oklahoma City. When you say "don't shoot the messenger," you're taking precisely the path those authors want you to take - accept the results they present at face value and be "shocked" into doing what they think is right. You're too smart for that, lee.The data behind those studies that paint such a horrible picture of Oklahoma are not scientific studies; they're compilations of data based largely on what one or two people "think" is right or the way things "oughta" be. And in worse cases, they bear no resemblance to the "facts" they are trying to sell. That's intellectual dishonesty at its worst - no matter how altruistic the motivations.

Should most Oklahomans eat better and exercise more? Almost certainly. To make that point, wouldn't it be simpler just to perform a survey on national exercise averages rather than construct this strawman stuff about gyms and commuting times? I think so. If we're the "fattest" city, shouldn't that just mean we, on average, weigh more than residents of other states? Probably, but I don't think that's the core data in the "fattest city" survey.

The problem is that doing pure, "clean" surveys and studies draws a much more boring, and more general conclusion that EVERYONE should be eating better and exercising more. ut doesn't afford these dramatic, headline grabbing opportunities to humiliate one or two cities or states as some low-class, high "offenders" of some purer faith. The "health crowd" has more than a sliver of self-righteousness about itself these days, and the liberties it takes in studies like these to be condescending to those who don't live as "they" think they should is more than a little tiring.

-soonerdave

[blabare]

It's a darn conspiracy to make the red states look bad right?

[SoonerDave]

It's a darn conspiracy to make the red states look bad right?

No, it's a conspiracy of bad research and shoddy journalism under the heading of "scientific research." Oklahoma just happens to be an unfortunate bystander.

-soonerdave

[Kerry]

It's a darn conspiracy to make the red states look bad right?

If this comment is directed at the Commonwealth study then your answer is yes, the choosing of colors to represent good and bad was intended to make Republican leaning states look bad. You can't take the politics out of a politically motivated report written by a politically motivated organization.

[Kerry]

Earlier in this post CuatrodeMayo made reference to the US News and World Report Best Hospitals Report 2006. This is another example of a non-scientific study being passed off as real research. The study used data from three areas to make their list; reputation, mortality, and other factors (their term not mine). The scores given for "reputation" and "other factors" come from doctor surveys.

For "reputation" only 47% of the 3,200 doctors that were sent sureveys responded to them. This 3,200 was selected at random from 860,000 doctors on the AMA master file. The 1504 doctors that responded represent only 0.17% of the AMA doctors, but it accounts for 33% of the final score, and the AMA is just one of several Medical assoications.

For the "other factors" ranking, so few hospitals responded that they had to fill in the gaps with surveys from 2003. I'm not sure why they used 2003 and not 2004 or 2005. To further skew the numbers the ranking of "other factors" also came from the same doctor survey reviewed above. We already know that only 0.17% of AMA doctors were used. This now means that 67% of the score came from a handful of doctors with enough time to fill out surveys.

In my opinion the only category that even makes sense in the whole "study" is the mortality rate but it used data from 2003, 2004, and 2005. But once again the raw data had to be manipulated based on a subjective ranking criteria called "severity". The more sever a patient was ranked the less impact that patient had on the mortality rate. In other words, one death doesn't necessarly equal another death.

At the end of the day it all seems like a bunch of made-up excriment to me and since we don't get to see the whole process who knows if the rules are change midstream to get the desired outcome.

[mecarr]

I think that it all goes hand in hand. If the people of Okla lived healthier then I think that you would see that our Health Care would be held in a higher regard, and we would not place 50th in the US with poor healthcare.

I have heard over the years that many of our top doctors have been leaving the state of Okla because of lack of tort reform. It was only a year or two ago that doctors of Okc had a stand in at the legislature trying to get help with malpractice suits and insurance. I don't know all of the facts but I don't think that anything has changed since then, at least I haven't heard.

Tort reform is a joke in my opinion. A big part of the tort reform movement is to cap "non-economic" damages at $300,000. Can you imagine going in for an operation and some doctor negligently cuts off the wrong arm or negligently treats your loved on resulting in death? I'm not saying that we should go off and reward every injured person $1 million, but let's at least let the jury decide what damage amount is appropriate and not the politicians in our state capitol.

[Easy180]

Tort reform is a joke in my opinion. A big part of the tort reform movement is to cap "non-economic" damages at $300,000. Can you imagine going in for an operation and some doctor negligently cuts off the wrong arm or negligently treats your loved on resulting in death? I'm not saying that we should go off and reward every injured person $1 million, but let's at least let the jury decide what damage amount is appropriate and not the politicians in our state capitol.

Problem is juries many times hand out enormous awards based mainly on their dislike of our health care system...Everyone hates how expensive our coverage, copays and deductibles are and they go in looking to get some payback for us common folk

I am definitely for a cap on everything but the most aggregious acts

[gmwise]

I think we need to live healther.
Stop blaming others when you can't say no to a double whatever this or a supersize that.
And not everything is govertment driven.
Good lord sometimes theres no devil behind it.
I think responsiblility should be the thing we need to changed, or indeed challenged ourselves.

[betts]

Tort reform is a joke in my opinion. A big part of the tort reform movement is to cap "non-economic" damages at $300,000. Can you imagine going in for an operation and some doctor negligently cuts off the wrong arm or negligently treats your loved on resulting in death? I'm not saying that we should go off and reward every injured person $1 million, but let's at least let the jury decide what damage amount is appropriate and not the politicians in our state capitol.

Letting the jury decide would be a wonderful idea if you truly got a jury of your peers. First of all, for a physician, who would your peers actually be? If not other physicians, other professionals?

Have you ever sat on a jury? Or have you, like most of the people I know, figured out a way to get out of jury duty because you had to work, were too busy with children/ illness in the family etc? That leaves the people who are thrilled to get out of work, the unemployed and the few truly civic minded people around to sit on a jury. Then, how many of them have even the rudiments of knowledge necessary to understand most malpractice cases? I'm a physician, and the questions my educated friends (in fields other than medicine) ask me are frequently frightening for their lack of understanding of basic medical facts.

Trust me, there are very few cases that come before a jury that involve the lopping of the wrong limb and other very serious cases of malpractice. Most of those are settled long before they come to court and most of those physicians (our motto: first, do no harm) are happy to compensate people who have truly been the victim of malpractice.

The cases that come to court are usually those the attorneys for the defendent think are defensible, or the ones the attorneys for the plaintiffs think are good for publicity or large off the wall damages. I've been lucky enough never to have been sued, but I've sat in court on one ridiculous case that even the jury was smart enough to realize was foolish. They returned a not guilty verdict in less than 10 minutes. Do you want to know how much it cost the insurance company to "win" that case 15 years ago? Approximately $90,000. Sadly, some of the other juries on equally ridiculous suits have not returned a not guilty verdict, frequently because the jury feels "sorry" for the plaintiff, regardless of the facts of the case. And, because they know the physician isn't paying, they frequently award ridiculously high damages, not realizing that we're all paying. Higher malpractice fees result in higher costs to the rest of us when we seek medical care.

I've been in court much more frequently as an expert witness, and I've seen how often lawyers for the plaintiff and defendent (in child abuse cases) twist medical facts, seek out obscure journals with one article that vaguely supports their case and try to overwhelm the jury with facts I can guarantee you most of them don't understand. So, the winner may end up being the one with the lawyer with the best courtroom presence, rather than the best case.

The best jury I've ever seen is a military jury. There at least the defendent gets a jury of his peers. The jury can actually ask the expert witness questions if they have them, and the witness can educate the jury in layman's terms. I wish we had more like them.

Sorry for the rant, but frivolous lawsuits are hurting all of us. I would have no problem with all cases in which the lawyer for the plaintiff truly thinks his/her case should be worthy of an award greater than $300,000 being reviewed by a panel of several doctors and several lawyers, and a special exception being made in those cases. But trust me, it would be the minority of cases right now.

[okclee]

Okla. #47 of 50 in overall health.

I am sure that this is more biased information against our great state of Ok. Remeber you can't trust or believe any of this information.

NewsOK: We can blame food, smoking for bad rating

Tue November 6, 2007
We can blame food, smoking for bad rating

Top 5 states: 1-Vermont, 2-Minnesota, 3-Hawaii, 4-New Hampshire,
5-Connecticut

Bottom 5 states:
46-Tennessee,
47-Oklahoma,
48-Arkansas,
49-Louisiana,
50-Mississippi


Staff Writer
Oklahomans eat too much, smoke too much and too often die from heart disease, researchers say, and only three states fared worse in a United Health Foundation state-by-state study of residents' health released on Monday.

In overall health for 2007, Oklahoma ranked 47th-worst, ahead of only Arkansas, Louisiana and Mississippi. Top-ranked states were Vermont, Minnesota, Hawaii, New Hampshire and Connecticut. Oklahoma dropped from 44th in 2006.

Oklahoma improved the least since 1990, and has only raised its overall score minimally since 1990 while the other states did better, according to the foundation's report.

Oklahoma ranked worst in the nation in cardiovascular deaths and 47th worst in prevalence of smoking, according to the report, "A Call to Action for People and Their Communities.”

In specific health categories, 25 percent of Oklahomans are listed as smokers and 29 percent of residents are considered obese.

"Since 1990, the prevalence of obesity increased from 11.6 percent to 29 percent,” noted the foundation's report about Oklahomans.

Obesity is defined as "an excessive accumulation of body fat, usually caused by the consumption of more calories than the body can use. The excess calories are then stored as fat.”

"This report is very disappointing,” said Pam Troup, a member of the executive committee of Central Oklahoma Turning Point, a health improvement initiative. "Despite many education programs, we're just not seeing changes in lifestyle behaviors. The best thing that could be done in Oklahoma would be for people to stop smoking and stop using all tobacco products.”

Oklahoma also was cited for limited access to primary-care physicians. That contributed to the state's low ranking, according to the national report.

Some 19 percent of Oklahomans lack health insurance and 21 percent of children live in poverty, the report stated.


What's the reaction?
In reacting to the report, public health authorities said several factors in the report aren't within their realm of control. The United Health Foundation's assessment also included measures of economic and social conditions that can affect health outcomes.
"Certainly, we are most disappointed that our state health status ranking has dropped,” Dr. Mike Crutcher, commissioner of the Oklahoma Health Department, said Monday.

"In the past year, Oklahoma has experienced some noteworthy achievements that we felt should have improved our state's health ranking.”

Crutcher said Oklahoma's immunization coverage for children from 19 to 35 months has improved from 44th to 25th in the nation — with 80.4 percent of these children now fully immunized against 10 diseases including polio and hepatitis B.

Other successes include a reduction in the state's infectious-disease rate, which has decreased by 60 percent since 1990.

Similarly, Oklahoma's smoking prevalence has decreased by 24 percent since 1990, although the annual rate has remained at about 25 percent since 2000, he said.

"Numerous organizations and initiatives — including the ‘Strong and Healthy Oklahoma' initiative and the Turning Point and Fit Kids coalitions — are working together throughout the state toward the common goal of achieving positive health changes,” Crutcher said.

"While we are disappointed in the new state health ranking, we are also even more determined to confront — and overcome — those challenges keeping our state from achieving significant health improvements,” Crutcher said.


How one state improved
New Mexico had a 4.5 percent increase in its health status over last year, and was ranked 38th in the report.
"We have doubled the number of school-based health centers across New Mexico, increasing students' access to free primary and behavioral health care in their schools,” said Deborah Busemeyer, spokeswoman for the New Mexico Health Department.

"We have expanded insurance coverage for business owners, workers, people with disabilities and every child up to age 12,” she said. "We have also created an ‘obesity interagency' to help state agencies collaborate.”

Officials with the Oklahoma Academy of Family Physicians said they are attempting to increase the number of general practice doctors in the state.

"Our efforts at the University of Oklahoma College of Medicine campus include introducing medical students to family medicine through preceptor programs with family physicians, monthly lectures relating to primary care, and community-outreach activities including hands-on clinics for the homeless and uninsured patients,” said Sam Blackstock, academy executive vice president.

"We are also even more determined to confront — and overcome — those challenges keeping our state from achieving significant health improvements.”

Dr. Mike Crutcher, health commissioner

NewsOK: We can blame food, smoking for bad rating

[jbrown84]

It baffles me how many people of my generation smoke despite being more than well educated on the dangers of it.

[Misty]

It baffles me how many people of my generation smoke despite being more than well educated on the dangers of it.

It makes you look cool.



kidding

[BFizzy]

So, Oklahoma is #47 in overall health.

okclee, what do you want our state's health care system to do to make Oklahoma healthier?